Rhogam Shot covered by insurance?

If you need the rhogam shot, is it covered by your insurance? I just went to go pick it up and it's costing me $200. I'll pay it obviously but would think it would be covered since it's a necessity. Calling insurance but curious if it's normally covered by insurance.

Rhogam Shot covered by insurance?

thats crazy that it wouldnt be covered. I would call the ins co and find out why.

Re: Rhogam Shot covered by insurance?

Nope. It's a very expensive shot, and I'm not sure why it is not covered.

Re: Rhogam Shot covered by insurance?

My last pregnancy I got one and it wasn't covered either.

Rhogam Shot covered by insurance?

I loathe the rhogam shot...loathe. I've had like 7 of them so I'm sadly a bit of an expert in this area. It's not covered through your prescription coverage, it's covered by your medical. I have Cigna and after a lot of confusion by pretty much everyone that works there we finally came to the conclusion that it is covered but not if you pick it up at a pharmacy. You need to use the pharmacy delivery through your insurance company and have them deliver the shot either to you or directly to your doctor's office. I don't know if it's the same with every insurance company but this was the case with mine. My doctor's office has it waiting for me and I didn't pay a penny.

Rhogam Shot covered by insurance?

Yes it is but with my insurance I needed to be pre approved which just meant a note from the dr-I needed it as an emergency with my first and paid out of pocket, got the approval which they predates then got an adjustment-it went against my injectible insurance

Re: Rhogam Shot covered by insurance?

I don't have experience with the rhogam shot but I'm Lovenex injectables. My husband works for the city so we have GHI. Our pharmacy insurance is CVS/Caremark but my injectables are covered by Express Scripts. So definitely call your primary insurance company and they should tell you who covers injectable medicine.

Re: Rhogam Shot covered by insurance?

Oh wow. I was covered by mine.

Re: Rhogam Shot covered by insurance?

It is covered by mine but i still had to pay $150. AND I needed twice last year
Luckiy when I got it for the third time (at 28 weeks) it was done in the hospital and was just billed with the hospital services.

Rhogam Shot covered by insurance?

I never knew it wasn't covered, we give it to our pts all the time while in the office.

If its part of your Dr visit is it covered??

Message edited 12/23/2015 3:51:59 PM.

Re: Rhogam Shot covered by insurance?

Mine have always been covered. Have had about 10 shots altogether....never an issue. (Mine were always done either in the hospital, or in a doctor's office setting.)

Rhogam Shot covered by insurance?

Good update (I think): After being tosses around from my Rx insurance to the medical insurance (the Rx plan said to contact medical and vice versa), I was informed that a specialty section of my Rx plan needed to receive the Rx and a pre-authorization and the injection would be sent directly to my doctor. Hopefully that will do it! I'll know after the holidays if it worked out. Thank you so much for all the suggestions!

Re: Rhogam Shot covered by insurance?

Re: Rhogam Shot covered by insurance?

Re: Rhogam Shot covered by insurance?